Interprofessional collaboration amongst health care professionals in Federal Medical Centre, Owo, Ondo State, Nigeria: A cross-sectional study

This study is anchored on the Interprofessional Collaborative Practice Framework proposed by the World Health Organization,^[5] which emphasizes teamwork, communication, role clarification, and shared decision-making as key determinants of effective IPC. The framework posits that when healthcare professionals from diverse disciplines work together with mutual respect and defined roles, patient outcomes and system efficiency improve. In the Nigerian context, contextual factors such as leadership style, institutional culture, and professional hierarchies influence the extent of collaboration.^{[6, 7]} The conceptual model for this study integrates individual-level variables (knowledge, attitude, and communication skills) and organizational-level variables (leadership support, teamwork culture, and policy environment) as predictors of IPC effectiveness. Improved IPC is expected to lead to enhanced patient care quality, reduced conflict, and improved professional satisfaction among healthcare workers in Nigerian health institutions.

Despite increasing global evidence supporting IPC, significant knowledge gaps persist within the Nigerian healthcare system. First, most Nigerian studies have focused on interprofessional conflict and rivalry rather than on the determinants of effective collaboration or its impact on patient outcomes.^{[6, 7]} Second, there is limited empirical data on how institutional culture, leadership support, and professional education influence IPC practices in Nigerian hospitals.^{[8, 9]} Third, while international studies emphasize the role of interprofessional education (IPE) in promoting teamwork,^{[10, 11]} few Nigerian institutions have implemented or evaluated such initiatives. Furthermore, comparative analyses between Nigerian and global IPC models are scarce, leaving a contextual gap in adapting international best practices to local realities. This study aims to bridge these gaps by assessing factors influencing IPC among healthcare professionals in Nigeria.

IPC has become a central component of modern healthcare systems, promoting teamwork among professionals from diverse disciplines to enhance patient outcomes. Globally, IPC has been associated with improved quality of care, patient safety, and reduced medical errors.^[12] The World Health Organization advocates IPC as a strategy for achieving universal health coverage through coordinated and patient-centred care.^[13] In high-income countries, structured team models and IPE have improved chronic disease management and continuity of care.^{[14, 15]}

In Nigeria, however, IPC faces multiple challenges. Studies reveal that poor communication, professional rivalry, and hierarchical barriers often hinder effective teamwork.^{[6, 7]} Mohammed et al. identified unclear role boundaries and leadership failures as contributors to recurrent inter-professional conflicts, which undermine healthcare efficiency.^[6] Despite these constraints, Nigerian healthcare workers increasingly acknowledge the value of collaboration. Opele reported that clinical personnel in tertiary hospitals view IPC as vital for knowledge exchange and improved decision-making.^[8] Likewise, Halilu et al. demonstrated that IPC enhanced workflow coordination in northern Nigerian hospitals, though structural limitations persisted.^[9] Among pharmacy professionals, Showande and Ibirongbe found positive attitudes toward interprofessional practice but noted limited institutional support and lack of formal IPE exposure.^[16]

International evidence corroborates that IPE is a key enabler of sustainable IPC. Saragih et al. and Jiang et al. showed that IPE interventions strengthen communication, teamwork competence, and shared accountability among health professionals. Nevertheless, contextual factors such as organizational culture and policy frameworks determine success.^{[10, 11]} Compared with global advances, Nigeria’s IPC landscape remains constrained by systemic and educational deficiencies.

Overall, existing literature affirms that IPC improves patient safety and professional satisfaction when adequately supported. Strengthening Nigeria’s health system will require embedding IPE, clarifying professional roles, and institutionalizing collaborative care policies that mirror successful global models.

IPC is widely recognized as the gold standard for effective healthcare practice. It is defined as the process whereby multiple health workers from different professional backgrounds work together with patients, families, caregivers, and communities to deliver the highest quality of care.^[17] Evidence consistently demonstrates that strong IPC improves efficiency, reduces duplication of services, enhances patient safety, and leads to better clinical outcomes.^[18] Collaboration has been shown to optimize medication management, minimize preventable adverse drug reactions, reduce hospital-acquired complications, and lower morbidity and mortality rates.^[19] In addition to patient benefits, IPC promotes cost-effectiveness, ensuring more sustainable use of scarce healthcare resources.^[20]

Furthermore, IPC contributes to workforce well-being by fostering supportive environments where professionals feel valued. Studies reveal that effective collaboration reduces stress, burnout, and turnover while increasing job satisfaction and organizational loyalty.^{[21, 22, 23]} It also enhances opportunities for interprofessional learning and reflective practice, leading to continuous professional development.^[24]

Given these benefits, IPC has been cited as a key strategy for healthcare reform globally, with increasing calls to institutionalize collaborative approaches within health systems.^[25]

The effectiveness of IPC depends on several core components: role clarity, trust and confidence, conflict resolution, collaborative leadership, and resilience in the face of adversity.^[26] Role clarity ensures that each professional understands their unique contributions to patient care while respecting the input of others. When roles are well defined, teams report higher performance, greater job satisfaction, reduced stress, and enhanced organizational efficiency.^{[21, 27]} Conversely, ambiguity leads to duplication, professional conflict, and inefficiency.

Trust and confidence are the foundation of teamwork. Trust develops gradually through personal contact, open communication, patient-centered approaches, and organizational cultures that foster fairness and respect.^{[22, 28]} Without trust, interprofessional relationships are fragile, and collaboration quickly deteriorates.

Managing professional differences is another key element. Healthcare teams are composed of individuals with diverse training, perspectives, and personalities, and it is inevitable that disagreements arise. Effective teams transform this diversity into an asset, leveraging multiple viewpoints to stimulate innovation and problem solving.^[29] Emotional intelligence, maturity, and mutual respect are critical for navigating these differences constructively.

Collaborative leadership emphasizes shared responsibility rather than hierarchical dominance. In this model, leadership is dispersed across the team, enabling collective decision-making and shared accountability. This approach fosters innovation, strengthens professional practice, and supports staff well-being.^[30] Collaborative leadership has been described as encompassing resource stewardship, boundary-spanning across disciplines, and a culture of mutual respect.

Finally, resilience in adversity is vital. Health professionals often confront challenges such as resource scarcity, complex patients, or staff shortages. In such situations, collaboration becomes more critical than ever. Teams that remain united under pressure, rather than resorting to blame-shifting, demonstrate the integrity necessary for effective patient-centered care.^[31]

Despite its recognized importance, IPC faces several barriers. A persistent challenge is professional dominance, particularly within hierarchical systems where physicians traditionally occupy the apex of authority.^[32] This often breeds resentment among nurses, pharmacists, and allied professionals who feel undervalued despite their critical contributions. Conversely, doctors may resist perceived encroachments on their autonomy. Such tensions can escalate in settings where roles overlap, as increasing specialization blurs traditional professional boundaries.^[33]

Communication breakdowns are another major impediment. Ineffective communication leads to misunderstandings, duplication of efforts, and medical errors. Moreover, lack of mutual respect and limited understanding of other professionals’ roles further undermine collaboration.^[34]

In addition, healthcare systems often reinforce siloed practices through education, policy, and organizational structures. For example, professional training programs frequently emphasize discipline-specific competencies without adequate exposure to IPE.^[26] This results in graduates who are clinically competent within their fields but ill-prepared for teamwork in complex healthcare environments.

Workforce pressures also contribute significantly. High workload, staff shortages, inadequate remuneration, and migration of health workers—often referred to as the “Japa syndrome” in Nigeria—erode morale and reduce opportunities for meaningful collaboration.^[25] Under such conditions, professionals may prioritize survival strategies over teamwork.

The health of a nation is inseparable from the strength of its healthcare system, and effective collaboration among professionals is a cornerstone of this strength. Poor IPC undermines patient safety, increases errors, and wastes scarce resources, outcomes that Nigeria, with its fragile health system, can ill afford. The Federal Medical Centre, Owo, Ondo State, provides an important case study for examining IPC because it is a referral facility serving diverse patient populations and employing professionals across multiple disciplines.

Understanding the perceptions and practices of healthcare workers regarding IPC in this setting is essential for identifying strengths, weaknesses, and opportunities for intervention. Such insights can guide hospital administrators, policymakers, and educators in developing strategies to strengthen collaboration, improve patient outcomes, and enhance the work environment.

In summary, IPC is indispensable for effective healthcare delivery, offering benefits that extend from improved patient safety and clinical outcomes to enhanced professional satisfaction and system efficiency. However, barriers such as professional dominance, poor communication, and systemic challenges continue to limit its full realization, particularly in Nigeria. Addressing these challenges requires deliberate strategies, including IPE, supportive leadership, and policies that foster equity and mutual respect among healthcare workers.

This study therefore seeks to assess the perceptions and practices of IPC among healthcare professionals at the Federal Medical Centre, Owo, Ondo State, Nigeria, thereby contributing evidence that can inform strategies for strengthening teamwork in the Nigerian healthcare system.

This study adopted a descriptive cross-sectional design to assess IPC among healthcare professionals at the Federal Medical Centre, Owo, Ondo State, Nigeria. The design was chosen because it enables the researcher to collect data from diverse professional groups at a single point in time, providing a snapshot of prevailing attitudes, perceptions, and practices regarding collaboration within the healthcare team.^[12] A cross-sectional design is also suitable for identifying patterns and associations among variables without manipulating the study environment.^[15]

The study was conducted at FMC Owo, a tertiary healthcare institution serving as a referral center for Ondo State and neighboring communities. The hospital has a multidisciplinary workforce comprising doctors, nurses, pharmacists, physiotherapists, laboratory scientists, administrators, and allied health professionals, providing an ideal setting for examining IPC in a real-world healthcare context.

The target population included all categories of healthcare professionals employed at FMC Owo as of January 2025. These included medical doctors, pharmacists, nurses, physiotherapists, medical laboratory scientists, administrators, and other allied healthcare personnel actively engaged in patient care or hospital administration.

The final sample size consisted of 185 participants, drawn from the various professional groups within the hospital. To ensure representativeness, a stratified random sampling technique was employed. Each professional category constituted a stratum, from which a proportionate random sample (approximately 10% of each group) was selected.

Stratified random sampling was chosen for several reasons:

1. Heterogeneity of the Population: The healthcare workforce at FMC Owo comprises distinct professional subgroups with varying roles, responsibilities, and hierarchical structures. Stratification ensures that all cadres are proportionally represented in the sample, minimizing sampling bias and improving the generalizability of findings.^[10]

2. Comparative Analysis: This technique enables meaningful comparisons between professional groups (e.g., doctors vs. nurses or pharmacists vs. administrators) regarding their level of collaboration, trust, and communication.

3. Precision and Reliability: By reducing sampling error within each stratum, the method increases statistical precision and enhances reliability of estimates compared with simple random sampling.^[15]

Data were collected using a pretested, structured Interprofessional Collaboration Scale (ICS) Questionnaire, which assessed five key dimensions of IPC: role clarity, ability to overcome personal differences, trust and confidence, collective leadership, and ability to overcome adversity. Responses were rated on a five-point Likert scale ranging from strongly disagree (1) to strongly agree (5). The questionnaire was adapted to the Nigerian healthcare context and reviewed by experts in health management and behavioral sciences to ensure face and content validity.

Trained research assistants from various professional backgrounds distributed the questionnaires to participants during work hours. The principal investigator supervised the process to ensure consistency and adherence to ethical standards. To enrich the quantitative findings, semi-structured interviews were conducted with selected participants to explore their experiences and perceptions of IPC in greater depth.

Completed questionnaires were checked for completeness and coded into statistical software (SPSS version 22) for analysis. Descriptive statistics such as means, standard deviations, frequencies, and percentages were used to summarize data. Composite IPC scores were calculated for each respondent, and comparisons across professional groups were conducted using appropriate ANOVA. To ensure accuracy and reliability, the data collected were carefully validated through multiple processes. First, the questionnaire was pretested among 20 healthcare professionals from a similar tertiary hospital to identify ambiguous or poorly worded items, and necessary adjustments were made. Expert review by senior academics and clinical supervisors in health management ensured content and face validity. During data entry, double-entry verification was employed to minimize transcription errors. Internal consistency of the instrument was assessed using Cronbach’s alpha, with a threshold value of 0.70 considered acceptable.^[35] Furthermore, random checks and cross-verification of responses were performed to detect missing or inconsistent data, ensuring that only complete and valid responses were included in the final analysis.

Ethical approval was obtained from the Research and Ethics Committee of FMC Owo (Approval No: FMCOWO/HREC/2024/134; Reference No: NHREC/FMCOWO-HREC/03/01/2024). Informed consent was obtained from all participants, who were assured of confidentiality, anonymity, and voluntary participation with the right to withdraw at any time without penalty. The study upheld the ethical principles of respect, beneficence, and justice throughout.

The study included a total of 185 participants who completed the survey, drawn from a larger staff pool across seven professional categories: Nurses (n = 322), Doctors (n = 201), Pharmacists (n = 52), Physiotherapists (n = 45), Lab Scientists (n = 73), Administrators (n = 347), and a miscellaneous category, “Others” (n = 430). “Others” represented as ancillary workers are the largest proportion of the respondents (44, 23.7%) followed by Administrators (37, 20%), then Nurses (34, 18.38%) and Doctors (21, 11.3%). A significant majority of participants across all groups identified as generalists. Demographically, the study population was generally young, with a large proportion of staff aged 20–39, and most reporting less than 10 years of service. Furthermore, females constituted the majority of the nursing (91.18%) respondent groups.

Table 1 summarizes the demographic distribution of the 185 respondents across seven professional groups. It presents gender, marital status, age categories, years of service, and specialization levels. The majority of participants were aged 20–39 years (77.3%) with a slight female predominance (61.1%). Most respondents had less than 10 years of service (65%), and only 15.1% were specialists, reflecting the impact of workforce migration. Nurses were predominantly female (91.2%), while laboratory science was male-dominated (87.5%).

Table 2 presents mean scores for the five domains of IPC (role clarity, personal differences, trust and confidence, collective leadership, and overcoming adversity) across professions. Doctors, nurses, and pharmacists consistently reported higher scores across all domains, while administrators and the “others” category demonstrated the lowest mean scores.

Table 3 compares how each professional group rated others on role clarity. Doctors and nurses were consistently rated highly by their peers, while administrators and “others” received lower ratings. Nurses and pharmacists rated doctors highest for role clarity, while physiotherapists rated nurses highest.

Table 4 shows how professional groups evaluated each other’s ability to overcome personal differences. Doctors, nurses, and pharmacists were rated more positively, with physiotherapists giving particularly high ratings to nurses. Lower scores were observed for administrators and “others,” suggesting weaker perceptions of conflict management in these groups.

Table 5 outlines trust and confidence ratings across professions. Doctors, nurses, and pharmacists again received the highest ratings, particularly from one another. Administrators and “others” consistently received lower ratings, indicating limited confidence in their roles within collaborative teams.

Table 6 highlights how professions evaluated each other in terms of collaborative leadership. Doctors and nurses were rated highest, while administrators and “others” were rated lowest. Interestingly, laboratory scientists gave very high ratings to doctors on this parameter.

Table 7 demonstrates how teams perceived one another’s ability to collaborate under adversity. Doctors and nurses scored highest, particularly in evaluations from peers, while administrators and “others” had the lowest ratings.

One-way ANOVA analysis demonstrated that perceptions of IPC differed significantly across the professional groups for all five dimensions assessed (p < .001 for all parameters) (see Table 8). This confirms that the collaborative environment is not uniformly perceived by healthcare workers. Consistently, Doctors and Nurses reported the highest mean scores, indicating the strongest overall positive perception of collaboration. Conversely, the “Others” category consistently reported the lowest mean scores across all five parameters, suggesting the poorest perceived collaboration, followed closely by Administrators.

Table 8 reports the results of ANOVA analyses comparing IPC domain scores across professions. Significant differences were found in all domains (p < .001), indicating that perceptions of IPC varied significantly by professional group.

Post-hoc analysis using the Games–Howell test provided critical insight into the perceived collaborative competence of specific target professions by their colleagues (see Table 9).

In the dimension of role clarity, Doctors and Nurses were rated significantly higher than Pharmacists and Lab Scientists (p < .05). This indicates a high consensus across the hospital staff regarding the clear and understood responsibilities of physicians and nurses. For instance, Nurses rated Doctors’ role clarity very highly (M = 4.53, SD = 0.46). However, professionals in the “Others” and Administrator groups were consistently rated as having the lowest role clarity, with some inter-professional ratings dipping below M = 3.00 (e.g., the “Others” group rating Administrators’ role clarity at M = 2.91, SD = 0.78), suggesting substantial ambiguity in their respective roles.

Perceptions regarding the ease of managing Personal Differences showed a clear hierarchy, with Doctors rated significantly higher than Nurses, who in turn were rated higher than Pharmacists, Physiotherapists, and Lab Scientists (p < .05). The Pharmacist group demonstrated a particularly strong positive perception of Doctors on this measure, assigning the highest recorded mean score in the entire study (M = 4.90, SD = 0.45). Conversely, the Others and Administrator groups were consistently rated lowest by their peers, suggesting greater perceived friction or difficulty in working with these categories.

The level of Trust and Confidence reflected a similar positive bias towards the clinical professions. Doctors were rated higher than Nurses and Pharmacists, who were rated higher than Physiotherapists and Lab Scientists (p < .05). The Lab Scientists, for example, rated Doctors quite high (M = 4.20, SD = 0.66) but rated the “Others” group low on trust (M = 3.00, SD = 0.76). The “Others” and Administrator categories again formed the lowest tier of perceived trust and confidence among their colleagues.

Perceptions of Collective Leadership were significantly higher for Doctors compared to Nurses, who were rated higher than Lab Scientists and Pharmacists (p < .05). This suggests that physicians are most often perceived as exhibiting shared responsibility and leadership in team settings. This perception was reinforced by Lab Scientists, who rated Doctors’ collective leadership at an extremely high mean of M = 4.90, SD = 0.50. The “Others,” Administrator, and Physiotherapist groups were rated lowest in their contributions to collective leadership.

Finally, the ability to successfully Overcome Adversity followed the established pattern, with Doctors rated significantly higher than Nurses, who were in turn rated higher than Pharmacists and Physiotherapists (p < .05). The “Others” and Administrator groups were consistently rated lowest in their perceived ability to overcome challenges as a team, with Lab Scientists also featuring in the lowest tier of this comparison. Nurses showed a particularly high rating of Doctors’ ability to overcome adversity

Table 9 provides pairwise comparisons of mean scores. Doctors and nurses consistently received the highest ratings across domains, while administrators and “others” were rated lowest. Pharmacists performed moderately well, while physiotherapists and laboratory scientists often occupied intermediate positions.

Figure 1 visualizes how each professional group rated others in terms of role clarity. Doctors and nurses show the strongest role clarity across ratings, while administrators and “others” demonstrate weaker clarity.

Figure 1.

Heatmap of role clarity scores of the target professionals

Figure 2 illustrates comparative ratings of how professions managed personal differences. Doctors and nurses are again perceived more positively, while administrators and “others” are less well regarded.

Figure 2.

Heatmap of personal difference scores of the target professionals

Figure 3 displays interprofessional perceptions of trust and confidence. The strongest trust is observed among doctors, nurses, and pharmacists, while administrators and “others” remain at the lower end of the scale.

Figure 3.

Heatmap of trust and confidence scores of the target professionals

Figure 4 depicts collective leadership ratings. Doctors and nurses are consistently rated highly across professional groups, whereas administrators and “others” receive comparatively low scores.

Figure 4.

Heatmap of collective leadership scores of the target professionals

Figure 5 shows ratings of how teams perform under adversity. Doctors and nurses are consistently perceived as resilient collaborators, while administrators and “others” are rated lowest across groups.

Figure 5.

Heatmap of overcoming adversity scores of the target professionals

Despite its robust design and adherence to ethical standards, this study faced several limitations. First, as a single-center cross-sectional study, findings from Federal Medical Centre, Owo may not be fully generalizable to other healthcare institutions in Nigeria, especially private or primary healthcare settings with different organizational cultures and structures.^[12] So, stratified random sampling technique was carefully selected to ensure that our study truly represent the opinion of the staff of FMC, Owo. Second, self-reported data obtained through questionnaires are prone to social desirability and recall bias, as participants may provide responses they consider professionally acceptable rather than reflecting their true attitudes.^[15] To reduce this recall bias, a semi-structured interviews and the use of structured questionnaire (data triangulation) were conducted with selected participants in the study. Moreover, data were collected anonymously. Additionally, the unequal representation of professional groups, particularly laboratory scientists and physiotherapists, may have limited the ability to detect profession-specific variations in collaboration. Finally, the cross-sectional design restricts causal inference, preventing assessment of temporal or intervention-related changes in IPC.^[10] This unequal representation of certain professions and study design type will form the basis for a multicentre study.